• Journal of Preventive Medicine and Public Health
• /
• 제46권6호
• /
• pp.319-328
• /
• 2013

Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

• 근관절건강학회지
• /
• 제14권1호
• /
• pp.13-25
• /
• 2007

Purpose: The purpose of the study was to identify the effects of Tai Chi self-help program on glucose control, cardiovascular risks, and quality of life in patients with type II diabetes. Method: The study subjects were 95 adults with type II diabetes recruited from five primary health centers and one outpatient clinic. The Tai chi self-help program was provided twice a week for 6 months. Outcome measures included blood glucose(HbA1c), cardiovascular risk checklist, and quality of life(SF36). Result: At the completion of 6-month program, HbA1c for Tai Chi group dropped from 6.79 to 6.59 without significant group differences. However, cardiovascular risk scores for Tai Chi group has been significantly reduced compared to the control group. In 6 months, quality of life (SF36) was significantly better for Tai Chi group especially in the areas of physical and social functioning. Conclusion: Tai Chi self-help program applied for type 2 diabetes patients has been partially effective to control cardiovascular risk factors, and some dimensions of quality of life. Tai Chi self-help program can be safely and easily applicable to primary care centers for diabetic patients and other people with chronic disease for their symptom management, and health promotion.

• 한국보건간호학회지
• /
• 제22권1호
• /
• pp.27-38
• /
• 2008

Purpose: To determine the degree of cardiovascular disease risk according to socioeconomic factors among midlife women in the community and thereby provide baseline data for the development of health promotion programs. Method: A total of 200 women participated in health screenings and a health survey. The survey was performed in November and December, 2006. The survey instruments included socioeconomic factors, health behavior (smoking and exercise), and family history. Biophysical measurement included BMI and blood pressure. Blood samples were drawn for glucose and total cholesterol tests. Results: The mean age was 52.5 years, 34.0% had received education less than 6 years, 70.0% earned a monthly income of less than \1,500,000, and 61.5% were homemakers. Cardiovascular disease risk was significantly different by age (BMI, systolic BP, and exercise), education (systolic BP), monthly income (T. cholesterol), marital status (smoking), and occupation (exercise). Most women had 2 or 3 cardiovascular disease risks. Older age, lower education, and lower income were significantly associated with increased cardiovascular disease risk. Conclusion: Efforts should be made to decrease the number and severity of cardiovascular disease risk factors for midlife women in the community by developing health promotion programs targeting to modify their cardiovascular disease risk factors.

• Journal of Chest Surgery
• /
• 제45권6호
• /
• pp.404-407
• /
• 2012

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

• 대한지역사회영양학회지
• /
• 제15권2호
• /
• pp.275-283
• /
• 2010

There are few studies reporting optimal waist circumference that can be utilized to prevent the incidence of cardiovascular disease (CVD). We evaluated the association of waist circumference and waist and hip circumference ratio (WHR) with incident cases of CVD developed over 6 years in a population-based prospective study including Korean adults. Analyses for receiver-operating characteristic (ROC) curve were performed with data for 1,733 men and 1,579 women who were aged 40 to 69 years and were free of a physician-diagnosis of CVD at baseline. Information on the diagnosis of CVD was periodically reported using interviewer-administered questionnaires and anthropometric measures were obtained by biennial health examinations. We newly identified 77 cases of CVD during a follow-up period between 2003 and 2008. On the basis of measures of diagnostic accuracy including minimum distance to ROC curve and Youden index, waist circumference of 85 cm for men, in particular for male nonsmokers, and of 80 cm for women and WHR of 0.88 to 0.90 for men and of 0.83 for women were found to be optimal cutoff points to identify individuals at CVD risks. The study also found that the use of the suggested optimal values for waist circumference show higher sensitivity and lower specificity compared with 90 cm for men and 85 cm for women, which are waist cutoff points given by the Korean Society for the Study of Obesity to define abdominal obesity for Korean adults. Although lower cutoff points of waist circumference (83 cm) and WHR (0.87) were observed to be optimal for male smokers compared with male nonsmokers, whether suggesting waist cutoff points specific to smokers is needed warrants further studies. After taking into account other cardiovascular risk factors including smoking, men with waist circumference of 85 cm or greater and women with 80 cm or greater were at an increased risk of CVD. Thus, these cutoff points of waist circumference may be able to capture more individuals at CVD risks contributing to the prevention of future development of CVD.

• Journal of Chest Surgery
• /
• 제32권11호
• /
• pp.1046-1048
• /
• 1999

A life-long anticoagulation for the prevention of ischemic cerebral events by thromboemboli has been conventionally introduced for the treatment of an atrial septal aneurysm. However, due to the recent decrease of the risks in the open heart surgery, the alternative therapeutic modality has been introduced for the prevention of complications of the anticoagulation. A 41-year old female with dizziness was admitted to our hospital. She was diagnosed a shaving atrial fibrillation and a cerebellar infarction, and an atrial septal aneurysm was detected by transesophagel echocardiography that was not detected by the transthoracic echocardiography. Surgery was approached to the right submammarial anterolateral thoracotomy. The atrial septal aneurysm was obliterated by a purse-string suture and plication. Surgial results were excellent with normal sinus rhythms and esthetically satisfying appearance.

• 보건교육건강증진학회지
• /
• 제33권4호
• /
• pp.1-9
• /
• 2016

Objectives: This review is to suggest strategies to reduce risk factors of non-communicable diseases (NCD) in South Korea. Methods: Prior research findings on the burden of NCD and associated risk factors and the effectiveness of intervention programs were reviewed. Strategies regarding the control of NCD risk factors were conceived. Results: The author presented research findings from the Global Burden of Disease study on the burden of non-communicable disease (NCD) and associated risk factors in South Korea. Strengths and limitations of population and high-risk strategies for preventing NCDs were introduced. The author also reviewed the evidence on the effectiveness of multiple cardiovascular risk factor interventions and community-based intervention programs on cardiovascular diseases conducted in industrialized countries. Finally, strategies to reduce NCD risk factors in South Korea were suggested. Conclusions: The evidence-based interventions and the importance of population strategies in NCD prevention were highlighted. The author indicated that strategies employed by unhealthy commodity industries to undermine effective public health policies and programs should be actively monitored. It has been suggested that effective high-risk strategies with ecological models to address social risks rather than medical risks among disadvantaged population should be further developed in South Korea.

• 보건교육건강증진학회지
• /
• 제31권4호
• /
• pp.37-49
• /
• 2014

Objectives: The aim of this study was to evaluate the effects of a lifestyle modification program for Korean adults with cardiovascular disease risk factors on their health behaviors and health status. Methods: A total of 448 adults with abdominal obesity and additional cardiovascular disease risk factors(high blood pressure, low HDL-cholesterol, high triglyceride or high blood glucose) were randomly assigned to either an intensive intervention group (IIG, n=216) or a minimal intervention group(MIG, n=232). Participants in the IIG received lifestyle modification program which consisted of health counseling with nutrition assessment, health booklet and health diary, while those in MIG received minimal information. Results: The participants in the IIG significantly improved dietary habits(p<.05), retrained eating(p<.001), external eating(p<.01) behaviors, leisure time physical activity(p<.05), dietary self-efficacy(p<.01), exercise self-efficacy(p<.01) and MetS score(p<.001) after 3 months. In addition, the participants in the IIG showed more improvement in dietary habits(p<.05) compared with those in the MIG. Conclusion: The lifestyle modification program was effective in improving some health behaviors, behavioral determinants and cardiovascular risk factors for a short term.

• 성인간호학회지
• /
• 제25권5호
• /
• pp.515-526
• /
• 2013

Purpose: The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease. Methods: The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group. Results: The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom. Conclusion: The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.

• Journal of Chest Surgery
• /
• 제47권5호
• /
• pp.451-457
• /
• 2014

Background: The balance of the risks and the benefits of cardiac surgery in the elderly remains a major concern. We evaluated the early and mid-term clinical results of patients aged over 75 years who underwent major cardiovascular surgery. Methods: Two hundred and fifty-one consecutive patients, who underwent cardiac surgery at Seoul National University Bundang Hospital between July 2003 and June 2011, were included in this study (mean age, $78.7{\pm}3.4$ years; male:female=130:121). Elective surgery was performed in 112 patients, urgent in 90, and emergency in 49. Results: Early mortality was 12.7% (32/251). Follow-up completion was 100%, and the mean follow-up duration was $2.8{\pm}2.2$ years. Late mortality was 24.2% (53/219). There were 283 readmissions in a total of 109 patients after discharge. However, the reason for readmission was related more to non-cardiac factors (71.3%) than to cardiac factors. The overall survival estimates were 79.2% at the 1-year follow-up and 58.4% at the 5-year follow-up. Patients who underwent elective surgery had a lower early mortality rate (elective, 4.5%; urgent, 13.3%; emergency, 30.6%) and better overall survival rate than those that underwent urgent or emergency surgery (p<0.001). Conclusion: The timing of cardiac surgery was found to be an independent risk factor for early and late mortality. Thus, earlier referral and intervention may improve operative results. Further, comprehensive coordinated postoperative care is needed for other comorbid problems in aged patients.